Fake It Till You Make It

How Fake Health Centers Manufacture Lies

The Hartford GYN Center is located in a working-class neighborhood of Hartford, Connecticut just off the intersection with Park Street—an avenue lined with Puerto Rican bodegas and restaurants that gave it its nickname “New England’s Spanish Main Street.” Since 1978, Hartford GYN Center has offered the Hartford community comprehensive reproductive care, including abortion services.

Yet, in May 2017, a so-called “crisis pregnancy center” opened next door, coincidentally under the name Hartford Women’s Center. The two facilities are 30 feet apart in identically nondescript brick buildings; an office directory include signs bearing their almost-identical names.1 Run by the Catholic organization St. Gerard’s Center for Life, the sole aim of Hartford Women’s Center is to trick women seeking abortion services at Hartford GYN into entering their facility instead, where they will be cajoled, lied to and/or scared away from pursuing an abortion.

According to former Hartford GYN Center administrator Jamie Beers, the staff at Hartford Women’s Center would open their doors as her patients would walk by to bring them into their facility and provide them with false information about abortion. In the words of St. Gerard’s director, Leticia Velasquez: “whatever it takes to have a woman give birth, we’re there for them.”2 This often translates into a commitment by Hartford Women’s Center’s staff to use whatever manipulative tactics they can to make sure women who cross their path are unable to access abortion services. This includes purposefully drawing Hartford GYN patients into their facilities so that they miss previously scheduled appointments for abortion care.

This small corner of Hartford is not unique: across the United States, fake health centers like Hartford Women’s Center are proliferating. There are more than 4,000 fake health centers nationwide,3 compared with around 800 abortion clinics.4 In other words, there are five fake health centers for every one abortion clinic. The vast majority of them are owned and operated by faith-based umbrella organizations, including the National Institute of Family and Life Advocates (NIFLA), Care Net and Heartbeat International (of which St. Gerard’s is a member). Presenting themselves as an “alternative choice” for women facing an unplanned pregnancy, they will use any means necessary to deceive and force women into continuing their pregnancies. Many of these fake centers can be found in the inner cities of places like Hartford, with the sole intent of targeting working-class communities and communities of color that often have fewer insurance options and/or medical resources available to them.

As in the case of Hartford Women’s Center, these fake clinics often set up shop next door to abortion clinics. Their websites and the interiors of their offices are modeled to look just like family planning centers.5 Their staff wear white lab coats to resemble medical staff, even though they have little to no medical training. Their deceptive tactics have become increasingly sophisticated over the years to better mimic real health facilities and present themselves as places for women to find information about their “choices.” In fact, many of these facilities bear the word “choice” in their names—but, once a woman is inside the facility, the last thing she is provided with are legitimate and medically accurate choices.

According to an investigative report by Vice, these unlicensed centers advertise medical-sounding services, including free pregnancy tests and “limited ultrasounds” by untrained staff for “bonding” purposes.6 Through the Knights of Columbus Ultrasound Program, increasingly more of these facilities have ultrasound machines to provide a “window on the womb.” 7 They claim to provide unproven treatments to “reverse” an abortion.8 They will often provide women false or inaccurate information that abortions can cause trauma or pose health risks such as infertility, breast cancer and birth defects (all of which have been debunked by the American College of Obstetricians and Gynecologists).

So how did we get here? And how are such sophisticated fraud techniques legal?

Fake health clinics have been operating since as far back as the late 1960s, but they have become more prevalent since the 1990s after a federal law prohibited blocking abortion clinic entrances.9 Since they are not licensed medical facilities, and are seen as centers of “religious outreach,” they do not have to abide by patient protections under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This is despite the fact that they make no pretext about pretending to be medical facilities and using medical equipment. This year, supporters of these centers were emboldened further when the US Supreme Court ruled in National Institute of Family and Life Advocates (NIFLA) v. Becerra that a California state law requiring these centers to provide women accurate information about abortion options likely violates the centers’ First Amendment rights.10

The popularity of these fake centers has also grown as the antichoice lobby tries to refashion itself with “compassionate conservative” branding. In many respects, fake health centers are part of an overall trend by new-wave antichoicers to hijack the messages and tactics of the prochoice movement as their own.11 Rather than holding graphic posters in front of abortion clinics, fake health center supporters use welcoming advertisements, pamphlets and other branding to lure women to their facilities. Like the Little Sisters of the Poor, the Masterpiece Cakeshop baker and other successfully branded “folk heroes” of the religious right, fake health centers have become the whitewashed standard-bearers of the antichoice lobby.

Fake health centers have always invested heavily in marketing to women with scarce resources and information. As Lizz Winstead describes in her deeply personal piece for the Huffington Post:

My experience with a fake clinic was in the late 1970s, before home pregnancy tests were widely available. In the pre-internet age, if you were a teen and needed help with ending an unintended pregnancy, the advertisements they plastered on buses and billboards saying, “Considering abortion? Call us! We offer free pregnancy tests, choices, and options,” were powerful. I had nowhere else to turn and that number on the poster was my best hope.

Today, however, these tactics have evolved as fake health centers combine offline and online tactics, from billboards to Google ads, to geo-target women in need of resources. Investigations by NARAL Pro-Choice America and others have found that most Google searches for “abortion clinic” in many major cities produce at least one ad for fake clinics, despite efforts by Google to identify and remove the ads for violating its deceptive-advertising policies.12

Fake health centers have also become more adept at outreach and marketing to working-class communities and communities of color. Patients with Medicaid coverage may find fake health centers on the lists provided to patients of facilities that provide free pregnancy testing. Some of these centers are also buying advertising on Black television and using targeted advertising on websites where they know Black women and Latinas are clicking. 13

According to the Family Research Council, fake health centers are developing special initiatives to target urban communities of color they see as “underserved.” From Harlem to Hartford, there are more than 200 of these centers in the heavily urban tristate area alone.14 Care Net, one of the largest networks of fake health centers, developed an urban initiative “to reach underserved and over-aborted people.” Heartbeat International has “urban initiatives” in Miami, Los Angeles and Pittsburgh. And an investigation of fake health centers in North Carolina found that more than 75 percent of them “operate in communities with higher-than-average populations of color.”15

As explained by the Colorado Organization on Latina Opportunity and Reproductive Rights (COLOR), these efforts to prey on communities of color are cruel attempts to mislead and disempower communities already struggling to make ends meet:16

For women who are poor, do not have transportation or paid leave from work and people who need to arrange for childcare, making a trip to a provider is already difficult. Making another trip after they have been lied to . . . may delay their access to care or push care completely out of reach.
These centers specifically try to advertise in places where people may not have access to a comprehensive clinic. They do Spanish language billboards in neighborhoods with a large number of immigrants and focus on areas where people may not have insurance and are trying to figure out how to get care. They present themselves as being a way to meet people’s needs. It is cruel, callous and unconscionable.

These facilities set a pretty low bar on their claims of impact in communities in need. In recent public testimony before the Council of the District of Columbia, the administrator of a local fake health center, a nun, proudly bragged about the number of diapers and blankets her facility had provided women.

Yet some states continue to siphon off government resources that were meant to empower underserved communities to these fake health centers. In 2013, 34 states directed money to fake clinics. In 2016, the Texas House of Representatives voted to move $20 million from the Commission on Environmental Quality to the state’s fake women’s health centers.17 According to data collected by ThinkProgress, seven states—Missouri, Indiana, Ohio, Pennsylvania, Michigan, North Dakota and Texas—have diverted Temporary Assistance for Needy Families (TANF) dollars meant to provide cash assistance to welfare recipients to instead fund fake health centers.18 And now, under President Trump, the Department of Health and Human Services has proposed regulations to reshape Title X funds so that federal funds meant for comprehensive family planning facilities serving low-income patients will be easier to award to fake health centers.

With the religious right having the ear of the current administration, we can expect to see more fake health centers appearing in America’s inner cities. And more efforts to normalize the use of deception and lies under the guise of free speech and religious freedom. Unless we have an honest conversation about the fact that religious freedom is not about imposing your beliefs at all cost—that it does not allow you to manipulate or lie to patients simply because they have fewer resources—then we will not be able to course-correct this dangerous trend of fake health centers that present themselves as an “alternative truth.”